Purpose or Case Report: This study aims to evaluate the efficacy and impact of portal vein interventions in pediatric patients; which includes recanalization with venoplasty or stenting and their effects on hepatic and splenic hemodynamics through pre- and post-procedural liver and spleen elastography.
Methods & Materials:
A cohort of patients (20) undergoing portal vein interventions for portal hypertension over the last 5 years at single center; Texas Children hospital were subjected to a series of liver and spleen elastography assessments before and after the recanalization procedure. Post-op follow was performed at 1 day, 1 month, 6 month and 1-year intervals. Elastography measurements, which assess tissue stiffness as an indicator of fibrotic changes and blood flow dynamics, were compared to determine changes in liver and spleen stiffness. The correlation between elastography findings and clinical outcomes, including improvement in portal hypertension symptoms and hepatic function, was also analyzed.
Results: Preliminary findings suggest that portal vein interventions result in significant alterations in liver and spleen elastography measurements. Post portal venoplasty or stenting, there was initially transient increase in the liver stiffness followed by notable decrease in liver stiffness, indicating a reduction in portal pressure and improved hepatic hemodynamics. Conversely, spleen stiffness also demonstrated changes, particularly initial transient decrease in the splenic stiffness reflecting adjustments in splenic blood flow and pressure dynamics. These changes correlated with clinical improvements in patient symptoms and liver function tests.
Conclusions: Portal vein recanalization has a measurable impact on liver and spleen stiffness as assessed by elastography, which may provide valuable insights into the effectiveness of the procedure and its effects on portal hypertension. Even in patients with normal doppler results, changes in the liver and spleen stiffness could potentially serve as an indicator for reintervention. Elastography can serve as a non-invasive tool for monitoring and assessing the outcomes of portal vein recannalization, potentially guiding therapeutic strategies and improving patient management in portal hypertension.